Ilić M, Milisavljević M, Maliković A, Laketić D, Erić D, Boljanović J, Dožić A, Štimec B V, Manojlovic R
Folia Morphol (Warsz). 2018;77(4):649-655. doi: 10.5603/FM.a2018.0033. Epub 2018 Apr 3.
Surgical procedures such as thenar flaps and radial artery (RA) harvesting call for an elaborate anatomical study of the RA's superficial palmar branch (SPB). The aim of this study was to describe the branching pattern of this vessel related to the morphometric characteristics and variations of this artery.
Twenty 4% formalin solution-injected hands were dissected. For the morphometric study we used another group of 35 human hands of adult persons, injected with methyl methacrylate fluid into the ulnar and radial arteries. As soon as polymerisation was completed, a 40% solution of potassium hydroxide was applied for corrosion. The vascular arterial casts were examined under the stereoscopic microscope and precise drawings of each specimen were made.
In the majority of cases (75%) SPB passed superficially, over the abductor pollicis brevis muscle. The mean diameter of the SPB, very variable depending on its length and field of supply, was 1.52 ± 0.49 mm, ranging from 0.8 to 2.7 mm. Developed SPB type, was present in 31.4% of hands, with the diameter of 1.7 mm and larger (mean 1.95 mm), continuing distally to become the radialis indicis artery, with an average calibre of 1.2 mm, and with important branches to the thumb. In most hands (68.6%), the hypoplastic SPB, was present, with a mean diameter of 1.17 mm, and the field of supply within the thenar area.
Knowledge of the SPB dominance and existence of anastomotic vessels in its field of supply are of importance to avoid the risk of possible ischaemic sequelae in the hand associated with harvesting the RA.
诸如大鱼际皮瓣和桡动脉(RA)切取等外科手术需要对RA的掌浅支(SPB)进行详尽的解剖学研究。本研究的目的是描述该血管的分支模式及其与该动脉形态学特征和变异的关系。
解剖20只注射了4%福尔马林溶液的手。对于形态学研究,我们使用了另一组35只成人手,向尺动脉和桡动脉内注射甲基丙烯酸甲酯液体。聚合完成后,应用40%的氢氧化钾溶液进行腐蚀。在立体显微镜下检查血管铸型,并为每个标本绘制精确的图。
在大多数情况下(75%),SPB在拇短展肌表面浅层走行。SPB的平均直径为1.52±0.49mm,因长度和供血区域不同而差异很大,范围为0.8至2.7mm。发达型SPB存在于31.4%的手中,直径为1.7mm及以上(平均1.95mm),向远端延续成为示指桡侧动脉,平均管径为1.2mm,并向拇指发出重要分支。在大多数手中(68.6%),存在发育不良型SPB,平均直径为1.17mm,供血区域在大鱼际区域内。
了解SPB的优势情况及其供血区域内吻合血管的存在对于避免在切取RA时手部可能出现缺血性后遗症的风险具有重要意义。